Extra ultrasounds not recommended as standard antenatal care

In most healthy pregnancies, scans are recommended and offered at around 12 weeks and between 18 and 20+6 weeks as part of the routine NHS antenatal pathway.  

Extra scans will be offered to women and birthing people with a more complex pregnancy, such as those with a history of certain pregnancy complications, when there is a higher chance that the baby will be small, or with conditions such as diabetes or high blood pressure. Extra scans will also be offered for people expecting two or more babies.  

Although recommended by health professionals, women or birthing people can choose to accept or decline any part of the screening programmes offered, including ultrasound scans. 

If you’ve had an ectopic pregnancy or molar pregnancy before, you should also be offered an early scan at 6 to 8 weeks to check that the baby is developing in the right place. 

Why two scans at these times?

“Scans at these times in your pregnancy are based on research and evidence about important stages of the pregnancy when the developing baby can be assessed for wellbeing, and when other screening tests may be offered,” Tina explains.   

Your first scan will confirm a due date, check your baby’s development at this stage, and to see if you’re having more than one baby. Additionally, at this point you will be offered tests to help screen if your baby has genetic conditions such as Down's syndrome, Edward's Syndrome or Patau's Syndrome, if you have opted to have these screening tests.  

The scan performed around 20 weeks is called the anomaly scan and will check baby’s growth, position of the placenta and to check that your baby is developing as expected. If any concerns are raised, you will be referred to a specialist team in a timely manner if required. 

What happens next?

“If any concerns are raised, women or birthing people are informed, and will be offered additional scans or expert fetal medicine review, when necessary,” Tina says. 

“For some people, further scans will be offered if there are concerns about the baby's growth or because of complications in a previous pregnancy. These specialised scans will usually involve checking blood flow in the placenta, which can be associated with high blood pressure or smaller babies. 

“Later in the pregnancy, women and birthing people will have antenatal checks with their midwife, and if there are any concerns i.e. about baby’s growth or if the baby is not positioned for a head-first delivery, a scan will be arranged to check presentation and to help inform birth planning. 

Parents should be rest assured that doctors and midwives are carrying out antenatal checks to ensure your baby is developing as expected and sonographers are trained to request additional scans when required.  

In the UK, we have evidenced-based guidance in place to support this, which means that some women or birthing people will have more scans throughout the pregnancy when required for medical reasons. 

Researchers and clinicians are always striving to improve care and outcomes for mothers, birthing people and babies.

There is evolving research being undertaken nationally, including how to improve care and outcomes for Black, Asian, and other minority ethnic women. 

For this reason, some maternity units may offer different pathways, participating in research studies, for example, exploring whether an early scan of placental function will reduce the rate of stillbirth.

Other maternity units are researching whether it is helpful check the presentation of baby at 36 weeks with an additional scan. You will be given the opportunity to participate in different studies if available at your hospital. 

We understand that some parents may be anxious about checking on their baby’s development, particularly when they have experienced loss, so might choose to pay for extra private scans for reassurance. 

Tina suggests that although a scan may give reassurance at that moment, having serial scans might cause unnecessary stress for some. “It’s important to discuss these feelings and emotions with your midwife or doctor so that they can support you or advise you further,” she says. 

Speaking to the press recently, Professor Asma Khalil, consultant obstetrician and vice president of the Royal College of Obstetricians and Gynaecologists warned that while some private scanning companies offer ‘full diagnostic checks’ which could pick up on problems with the baby, others might just produce a 3D or 4D image of the baby, so it’s important that private sonographers explain exactly what type of scan they’re doing. 

If you do choose to pay privately for extra scans, make sure the service is registered with the Care Quality Commission.